MS 262 Peace Corps Medical Services Program

MS 262: Peace Corps Medical Services Program
MS 262 Peace Corps Medical Services Program

Date: December 2, 2013
Responsible Office: OHS/OMS
Supersedes: 11/16/05; 12/15/95; 11/22/82; 4/10/85
Issuance Memo of December 7, 2006

Issuance Memo
Attachment A
Table of Contents
1.0 Authority
2.0 Purpose
3.0 General Policies
4.0 Medical Screening
4.1 Medical Clearance
4.2 Medical Examinations
4.3 Standard for Medical Clearance
4.4 Appeal Process
5.0 Health Program for Trainees and Volunteers
5.1 Medical Services in Country of Service
5.2 Eligibility for Health Care Outside of Country of Assignment
5.3 Eligibility for FECA for Illness or Injury in the U.S.
5.4 Family Visits to Ill or Injured Volunteers
6.0 Completion or Early Termination of Service Evaluations
6.1 Peace Corps Medical Officer's Responsibility for Evaluations
http://inside.peacecorps.gov/index.cfm?viewDocument&document_id=4828&print=1[2/3/2014 2:25:10 PM]
6.2 Examination Scheduling and Location
6.3 Follow-up Treatment Based on Examination Results
6.4 Refusal to Submit to COS Examinations
7.0 Post-Service Medical Benefits

8.0 Medical Care for Children or Non-Volunteer Mothers
8.1 Care for Minor Dependents
8.2 Care for Non-Volunteer Mothers
9.0 Abortion
9.1 Medical Evacuation
9.2 Medical Expenses of an Abortion
9.3 Reproductive Health Services
10.0 Effective Date
1.0 Authority
22 U.S.C. 2504(e), (m)(2); 22 C.F.R. 305.2
2.0 Purpose
This manual section describes the Peace Corps medical services program for applicants, Trainees, Volunteers,
Returned Volunteers, and authorized dependents.
3.0 General Policies

3.1 The Peace Corps, through its Office of Medical Services (OMS) and its Peace Corps Medical Officers
(PCMOs), manages a health care system applicable to applicants, Trainees and Volunteers (V/Ts), Returned
Peace Corps Volunteers, and authorized dependents. Under the system, applicants are screened to
determine whether they can be cleared as medically eligible for service, V/Ts are provided all necessary and
appropriate medical care during the course of their service, and certain limited services are provided to
Returned Volunteers.
3.2 Because V/Ts face significant health risks, and immediate access to health care overseas is often
limited, V/Ts are expected to follow both Peace Corps medical policies and the medical advice of their
PCMO. V/Ts who refuse to take required immunizations/vaccinations and medical prophylaxes will be
administratively separated, as set out in MS 284 Early Termination of Service. In addition, a V/T who
consistently fails to follow other medical advice or policies may be administratively separated, where such
failure poses a serious risk of harm to the V/T or others.
3.3 Applicants for Peace Corps service must sign an authorization that permits Peace Corps staff and
contractors to use protected health information for medical screening and placement purposes to the extent
necessary to administer the Peace Corps program. The authorization form is included in the Volunteer
application and is also available in Attachment A. No applicant will be considered for service until the
authorization is signed.
4.0 Medical Screening

4.1 Medical Clearance

An applicant must be given medical and dental clearance before being accepted for Peace Corps service.
OMS's medical screening unit makes the determination on whether an applicant is cleared medically for
Peace Corps service.
4.2 Medical Examinations

All applicants must undergo prescribed physical and dental examinations to provide the information needed
for medical clearance determinations and to serve as a reference for future Volunteer health issues and any
future disability claims. Peace Corps will reimburse a prescribed amount for the basic medical/dental
examinations and laboratory work. Any additional examination costs or expenses for consultations,
evaluations, or treatment must be paid by the applicant.
4.2.1 The physical examination, which may include evaluations by specialists, if necessary, must be
obtained prior to medical clearance.
4.2.2 The dental examination for applicants must include a full-mouth (or Panorex) and bite-wing Xrays and the applicant?s dentist must fill out the Peace Corps dental examination form. Any
orthodontic or special dental treatment must be completed for dental clearance.
4.2.3 Final medical and dental clearance is required before an applicant will receive a ticket to a
staging event.
4.3 Standard for Medical Clearance

4.3.1 The Peace Corps regulatory standard for medical clearance is whether the applicant, with or
without reasonable accommodation, has the physical and mental capacity required of a Volunteer to
perform the essential functions of the Peace Corps Volunteer assignment for which he or she is
otherwise eligible, and be able to complete a 27-month tour without unreasonable disruption due to
health problems. In determining what is a reasonable accommodation, the Peace Corps may take into
account the adequacy of local medical facilities. In determining whether an accommodation would
impose an undue hardship on the operation of the Peace Corps, factors to be considered include:
(1) The overall size of the Peace Corps program with respect to the number of employees and/or
Volunteers, size of budget, and size and composition of staff at post or assignment;
(2) The nature and cost of the accommodation; and
(3) The capacity of the host country agency to which the applicant would be assigned to provide
any special accommodation necessary for the applicant to carry out the assignment.
4.3.2 Based on information from the applicant and his or her physicians, current medical research,
screening guidelines developed by OMS, knowledge and experience of the nature of Peace Corps
service, and information about the scope of medical care available overseas, an applicant will be
determined to be:
(a) Medically qualified for any country;
(b) Medically qualified with accommodation, which may limit country of assignment, or in some
cases, require specific site approval;
(c) Medically not qualified; or
(d) Deferred for a specific period of time, in order to determine whether a medical condition is
stable.
4.4 Appeal Process

An applicant may request review of a decision of the medical screening staff by submitting new information
to OMS.The information will be reviewed by a physician, and, unless the physician agrees with the request,
by the Screening Review Board (SRB).Procedures for such review shall be approved by the Office of the
General Counsel.The SRB will include as voting members at least one physician and four other OMS health
care professional staff persons.In any case involving review of issues of mental health, at least one
professional staff person from OSS should also participate as a voting member. Representatives from the
Office of the General Counsel and other agency offices may participate as advisors, as appropriate.The
decision of the SRB constitutes a final agency action and is not subject to further appeal.
5.0 Health Program for Trainees and Volunteers

V/Ts will be provided with all necessary and appropriate medical care during the course of their Peace Corps
service. A comprehensive health care program for V/Ts is managed and implemented in-country by the post
PCMO under administrative supervision of the Country Director (CD) and with professional guidance and oversight
from OMS. Some Peace Corps countries are served by an Area Peace Corps Medical Officer (APCMO). An APCMO is
a physician who, in addition to serving as a physician advisor in a base country, supports PCMOs in one or more
neighboring countries. Health care services in the United States or third countries (such as U.S. pre-service and
stagings, during travel in or medevac to the U.S or third countries) are managed by the OMS staff or PCMO, if
any, in the third country.For the purposes of providing health care, Peace Corps service is considered to begin
when the person begins travel directly to a staging event. The health care program includes:
(a) Pre-service immunization and prophylaxis as described in the OMS Technical Guidelines, as well as
regular immunization and prophylaxis as necessary throughout the term of service;
(b) Clinical care throughout service;
(c) Health orientation and education throughout service;
(d) Evaluation of health conditions at potential sites for Volunteer placement; and
(e) Other health support for Volunteers at their sites through site visits, when appropriate.
5.1 Medical Services in Country of Service

V/Ts will receive all necessary medical care and services primarily through, or under the direction of, the
PCMO at post and through local health care providers in country, as necessary. Prior authorization from the
PCMO is required (except in emergencies) for all medical and dental care not provided directly by the PCMO
(or, where available, an APCMO). In appropriate situations, a Volunteer may be medically evacuated to the
United States or some other destination when an illness, injury, or other medical necessity requires
evaluation and/or treatment beyond the scope of care available in-country. See MS 264, Medical
Evacuation.
5.2 Eligibility for Health Care Outside of Country of Assignment

The medical care for V/Ts during their service includes care when they are outside of their country of
service. Such care will generally include medical care for any illness or injury incurred during travel directly
to a U.S. pre-service staging or training site, or while on leave or official business in the U.S. or a third
country. Prior authorization from OMS staff or the PCMO or APCMO is required (except in emergencies) for
all medical and dental care while out of the country of service.
5.3 Eligibility for FECA for Illness or Injury in the U.S.

Post-service medical services for V/Ts, including eligibility for benefits under the Federal Employees'
Compensation Act, are described in MS 266 Post Service Medical Benefits for Volunteer, Trainees, and
Dependents. Although the Peace Corps provides medical care for V/Ts while they are in the U.S. during
their term of service, they are not eligible for FECA benefits for any non-service-related illness contracted or
injury suffered in the U.S.
5.4 Family Visits to Ill or Injured Volunteers

Peace Corps does not provide travel or related expenses for family members to visit a V/T who is ill or
injured.
6.0 Completion or Early Termination of Service Evaluations

Upon completion or early termination of service, each V/T must undergo medical and dental examinations in
accordance with the Office of Medical Services Technical Guidelines to identify existing unmet medical and dental
needs, complete routine evaluations, identify any potential medical issues, and provide a reference for any future
claims under FECA. See MS 266 Post Service Medical Benefits for Volunteer, Trainees, and Dependents.
6.1 Peace Corps Medical Officer's Responsibility for Evaluations

The PCMO is responsible for planning and conducting, or using local providers to conduct, completion of
service (COS) and early termination medical and dental examinations. Regardless of who conducts the
examinations, the PCMO must ensure that all components of the COS Evaluation (as outlined in OMS
Technical Guidelines) are completed.
6.2 Examination Scheduling and Location

V/Ts are generally required to undergo their examinations in-country prior to COS or early termination. COS
examinations may be administered up to 60 days prior to completion of service. Consideration will be given
on a case-by-case basis to permitting evaluations earlier than 60 days prior to COS. In addition, on a caseby-case basis and with guidance from OMS, the PCMO may authorize a V/T to obtain completion of service
examinations upon return to the United States.
6.3 Follow-up Treatment Based on Examination Results

In some cases, examination results may indicate the need for immediate follow-up care, which may delay or
accelerate departure by a V/T. COS or early termination may be delayed for up to two weeks in consultation
with OMS when the termination examination reveals an untreated medical problem or one requiring further
diagnosis.
6.4 Refusal to Submit to COS Examinations

V/Ts who refuse to submit to the COS examination or diagnostic studies or who refuse to await PC/W advice
regarding medical problems, must sign a statement before completion of service acknowledging their refusal
and their understanding that the refusal may affect their rights under FECA. V/Ts who refuse examination,
diagnosis or medical advice for dependents will sign the statement on behalf of their dependents. This
statement or other documentation of a V/T's failure to sign such a statement shall be filed in the Volunteer's
medical record.
7.0 Post-Service Medical Benefits

V/Ts and Returned Volunteers may in appropriate cases receive authorization from the OMS post-service unit for
post-service medical and dental evaluation of a service-related condition. These authorizations, which are for
evaluations only, and not for treatment, must be used within six months after the V/T closes service. After Peace
Corps service, Returned Volunteers may apply for payment for treatment and/or for a service-related illness or
injury under FECA, which is administered by the Office of Workers' Compensation Programs (OWCP), U.S.
Department of Labor. The scope of post-service benefits for which Returned Volunteers are eligible is set forth in
MS 266 Post Service Medical Benefits for Volunteer, Trainees, and Dependents.
8.0 Medical Care for Children of Non-Volunteer Mothers
8.1 Care for Minor Dependents

The Peace Corps will provide medical are for minor dependents of V/Ts who live with the V/Ts during their
service. Except where otherwise stated (see MS 206; MS 262; and MS266), the scope of care will be the
same as for V/Ts.
8.2 Care for Non-Volunteer Mothers

Where a V/T is married to a non-Volunteer mother or has taken action to acknowledge paternity which,
under local law, will make him financially and legally responsible for the care and supportofthechild,Peace
Corps will provide prenatal and birth-related care of the non-Volunteer mother in order to protect the health
and safety of the unborn child. Peace Corps will pay for such care for the non-V/Tmother only while the
Voulnteer is in service. Peace Corps will pay for such care for the non-V/T mother regardless of her
citizenship. No other medical care or other benefits are provided by PeaceCorpsfor a non-V/T mother.
The birth of the child should be documented on the appropriate form which is sent to the Volunteer Financial
Office.
9.0 Abortion
9.1 Medical Evacuation
A V/T who decides to have an abortion will be medically evacuated at Peace Corps expense to a location
where medically adequate facilities for obtaining counseling and an abortion are available and where
abortions are legally permissible. OMSis responsible for providing guidance to the PCMOregarding the
location of facilities that meet these criteria. The V/T may not be medically evacuated to a different site for
an abortion without prior approval by OMS.
9.2 Medical Expenses of an Abortion
When a V/T elects to have an abortion, the medical expenses directly related to the abortion procedure will
be the responsibility of the V/T. As a matter of law, the Peace Corps may not pay these costs. However,
the Peace Corps will pay for medical expenses incurred due to complications. The V/T should be advised
that she may make a withdrawal from her accrued readjustment allowance to pay for the procedure. To
preserve her medical confidentiality, such a withdrawal request should be made to the Office of the Chief
Financial Officer (CFO/VPS).
9.3 Reproductive Health Services

After the abortion procedure,if the V/T is medically cleared and wishes to return to country, she will be
offered reproductive health services.
10.0 Effective Date

The effective date is the date of issuance.
Date:
Authored By Tyler Posey

Dec 07, 2006

MS 262 Peace Corps Medical Services Program

Uploaded by

Document Information

Copyright

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

MS 262 Peace Corps Medical Services Program

Uploaded by

Copyright:

MS 262: Peace Corps Medical Services Program